Physical distancing should last months, not weeks, says epidemiologist

A sign is posted in a park reminding people to practice social distancing Wednesday, March 25, 2020, in Houston, Texas. (AP Photo/David J. Phillip)

Physical distancing and working from home is the new reality for most Canadians. Unfortunately, this new reality may last more than a few weeks, longer than most Canadians had anticipated, according to one epidemiologist.

“If you’re an optimist we’re talking about social distancing for about 12 weeks, if you’re a pessimist you should believe about 24 weeks,” said Dr. Gerald Evans, Chair and Medical Director of Infection Prevention & Control at Kingston Health Sciences Centre.

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Physical and social distancing refers to the practice of leaving at least a six foot distance between yourself and the person nearest to you, while also eliminating non-essential behaviour.

“These kinds of social distancing and public health measures are going to have to go on for months, not weeks,” said Dr. Evans.

Data shows the rate of COVID-19 infections is climbing every day in Canada with the country hitting its current peak of 701 cases on Mar. 24. Evans said Canadians have to be ready to wait out the storm.

This past weekend numerous photos surfaced online of Vancouverites congregating in beaches and parks disobeying Canadian public health officials advice to physically distance. However, Evans notes expecting people to be entirely comfortable in accepting a drastic change can be a daunting task.

“It takes a little bit of time to wrap yourself around a change in your life routine, and I think that’s a little of what we saw this past weekend,” he said. “It takes a little time for all of society to wrestle with the issue.”

Evans' estimate of three to six months of physical and social distancing may seem harsh, but he says if Canadians want to avoid a similar COVID-19 outbreak like Italy, they need to be in it for the long haul.

In terms of Canada’s response at the federal and provincial levels, Evans points to the measures put in by countries to implement physical distancing.

Both Quebec and Ontario’s provincial government took the stance of taking power out of people’s hands by ordering mandatory closures of all non-essential workplaces by Tuesday evening. The closures will last at least 14 days.

After its first confirmed case of COVID-19, the Northwest Territories banned non-essential travel into the area. In Atlantic Canada, Prince Edward Island’s government is telling people who are traveling from outside the area, even other parts of Canada, that they will need to self-isolate for 14 days.

Following South Korea’s model

After the first few patients in Canada tested positive for COVID-19 and the WHO declared an epidemic, Evans was pleased with Canada’s response to get the health system up and running.

“We’re way ahead of curve considering all the places where this has hit very badly like Italy and Iran,” said Evans.

With early implementation of testing measures and with residents following recommendations of physical distancing, Canada could flatten the curve.

“Our situation may be like the better situations of South Korea, Singapore and even Japan to some extent,” Evans said.

The World Health Organization (WHO) has pointed to South Korea as one of the countries who effectively flattened the curve.

In a single day, Feb. 29, there were 909 new cases in the country of 50-million-plus, but through measures of social distancing and aggressive testing they were able to limit the spread.

One of the things holding Canada back from reaching South Korea’s 20,000 tests per day is not having access to the materials needed by healthcare professionals, due to a halt in manufacturing in China and Italy.

There’s a stark difference between South Korea’s mortality rate of 0.94 pet cent to Italy’s 9.6 per cent, where at least 600 people have died per day since March 20.

“The epidemic [in Canada] appears to be relatively small [according to tested numbers] and there is evidence of spread, but you’re not seeing a cluster of deaths like in Italy,” said Dr. Jerome Kim, Director General of the International Vaccine Institute .

One of the reasons for the lower mortality rates in South Korea is a result of the country having prior experience dealing with the Middle East respiratory syndrome-related coronavirus (MERS-CoV) in 2015, from which 38 people died.

According to Kim, South Korea’s government started to take greater precautions and preventative methods to avoid another outbreak.

“With everything preparedness helps...the last preparedness drill was in December, they had no idea [COVID-19] was coming, but it was useful,” says Kim.

Messaging is key

According to Kim, one of the first things the South Korean government did was communicate to the country of more than 50 million people through social media and broadcast channels that they needed to follow physical distancing.

“They were transparent...the messages were clear, they were simple,” he said.

But most of the credit in reducing the outbreak belongs to South Koreans who heeded the advice of public health professionals without needing government or military intervention.

“The [government] gave people advice and they followed it. Koreans had experienced an outbreak before and nobody wanted to get infected,” he said.

Even now, a month removed from the physical and social distancing recommendations, South Korean are still abiding by the recommendations.

“You’re starting to see some people out, but it’s nothing like what you would see on a normal day,” he said. “People are still respecting the idea that they should be physically distancing.”

Evans is cognizant of South Korea’s methodology and the willingness of their people to limit the spread and hopes Canadians will follow suit.

“Be patient, it’ll take months, but when everything is safe, people can and should resume their lives,” he said.